Literature on technology assessment strongly emphasizes the need for evaluating the effect of technology on patient outcomes such as improved physical, functional, or emotional well being. This project is significant and unique because it will evaluate patient outcomes of the emerging screening and diagnostic technologies of optical spectroscopy and quantitative cytology and pathology during the developmental process. Because receiving positive Papanicolaou smear results and undergoing colposcopy and biopsy is associated with patient distress and problematic adherence to treatment and follow-up, we will focus on outcomes related to patient psychological distress, satisfaction, and adherence. In the trial of optical spectroscopy and multispectral digital colposcopy in Project 2 we will evaluate differences in patient pain and anxiety caused by Papanicolaou smear, colposcopy, biopsy, and optical spectroscopy or multispectral digital colposcopy. We also will assess patient satisfaction and preferences for the follow-up and treatment procedures of the various testing strategies. In the randomized clinical trial of optical spectroscopy in Project 3 we will study the impact of adding optical spectroscopy to colposcopy to diagnose high grade SIL, and the effect of immediate treatment on patient adherence, distress, satisfaction, and quality of life. Finally,we will conduct a qualitative study of community health care providers' receptivity to the innovations of optical spectroscopy and quantitative cyto-histopathology. Taken together, these studies will assess patient outcomes relevant to optical spectroscopy and quantitativecy to-histopathology, and will be used to improve the technology, facilitate its diffusion and implementation in health care practice, and improve patientcare.